Invited Commentary: Body Mass Index and Risk of Dementia-Potential Explanations for Life-Course Differences in Risk Estimates and Future Research Directions.
Invited Commentary: Body Mass Index and Risk of Dementia-Potential Explanations for Life-Course Differences in Risk Estimates and Future Research Directions.
复制标题
特邀评论：体重指数和痴呆症风险——风险估计和未来研究方向生命历程差异的潜在解释。
DOI：
10.1093/aje/kwab095
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发表时间：
2021
影响因子：
5
通讯作者：
Brenowitz,WillaD
中科院分区：
文献类型：
--
作者：
Brenowitz,WillaD
身体质量指数（BMI）与老年人健康状况（包括痴呆症）之间的关系仍存在争议。许多研究发现，在老年人中，身体质量指数与痴呆呈负相关，而在其他研究中，中年时身体质量指数高与痴呆风险增加有关。在这一期中，Li等人（Am J epidemiology . 2021;190(12): 2503-2510）利用Framingham后代研究的广泛随访研究了中年至晚年的BMI和痴呆风险。他们发现BMI和痴呆之间的关系从中年（40-49岁）的正相关转变为晚年的反向趋势。他们的工作证明了在整个生命过程中研究痴呆症风险因素的重要性。中年肥胖可能是痴呆症的一个重要的可改变的风险因素。然而，由于早期痴呆可以导致体重减轻，反向因果关系仍然是偏见的关键来源，可以解释BMI和老年痴呆之间的反向趋势。其他偏差的程度也不清楚，包括未测量的混淆，BMI作为肥胖测量的不准确性，或选择性生存。三角测量身体成分和痴呆风险的证据可以为痴呆干预提供更好的目标，但未来的工作将需要评估具体的途径。
The relationship between body mass index (BMI) and health outcomes of older adults, including dementia, remains controversial. Many studies find inverse associations between BMI and dementia among older adults, while in other studies high BMI in midlife is associated with increased dementia risk. In this issue, Li et al. (Am J Epidemiol. 2021;190(12):2503–2510) examine BMI from mid- to late life and risk of dementia using the extensive follow-up of the Framingham Offspring Study. They found changing trends in the association between BMI and dementia from a positive association for midlife (ages 40–49) to an inverse trend in late life. Their work demonstrates the importance of studying dementia risk factors across the life course. Midlife obesity might be an important modifiable risk factor for dementia. However, because incipient dementia can lead to weight loss, reverse causation remains a key source of bias that could explain an inverse trend between BMI and dementia in older ages. The extent of other biases, including unmeasured confounding, inaccuracy of BMI as a measure for adiposity, or selective survival, are also unclear. Triangulating evidence on body composition and dementia risk could lead to better targets for dementia intervention, but future work will need to evaluate specific pathways.